| Lumberton Dental Clinic Pa | |
|
7935 Us Hwy 11 Lumberton MS 39455 | |
| (601) 796-8449 | |
| (601) 796-9225 |
| Full Name | Lumberton Dental Clinic Pa |
|---|---|
| Speciality | Dentist |
| Location | 7935 Us Hwy 11, Lumberton, Mississippi |
| Authorized Official Name and Position | William Henry Vann (GENERAL DENTIST PRESIDENT) |
| Authorized Official Contact | 6017968449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumberton Dental Clinic Pa Po Box 431 Lumberton MS 39455 Ph: (601) 796-8449 | Lumberton Dental Clinic Pa 7935 Us Hwy 11 Lumberton MS 39455 Ph: (601) 796-8449 |
| NPI Number | 1982726824 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982726824 | NPI | - | NPPES |
| 00064465 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 173676 (Mississippi) | Primary |